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E. Playán, N. Čereković, Mihajlo Marković, Z. Vaško, M. Vekić, Alen Mujčinović, S. Čadro, Đurađ Hajder et al.

Bosnia and Herzegovina (BiH) accumulates challenges in the areas of research and innovation (R&I), agricultural water management (AWM) and their intersection. In the decade 2012–2022, the BiH gross domestic product per capita in current US$ increased by 6.2% annually. However, improvements are slowly arriving in R&I and AWM. In this period, relevant challenges to AWM have materialized, such as climate change effects or the need to implement an interconnected vision of ecosystem services. In the R&I arena, the societal demand for knowledge goods remains low, while the reforms of higher education and R&I funding systems have become urgent. This paper set out to elaborate a realistic and feasible policy roadmap to consolidate R&I in AWM in BiH. The methodology included an assessment of policies and sector performance, the analysis of stakeholder perceptions, the development of strategic directions and the design of a strategy. Desk research and stakeholder consultations (33 interviews, six workshops, 179 persons in total) were used to take stock of the current situation and expectations for the future. Stakeholders were divided into knowledge supply and knowledge demand, with five and six subcategories, respectively. Relations were established among the key enabling factors, the needs and the capacities of the involved stakeholders. The TOWS (Threats, Opportunities, Weaknesses and Strengths) matrix permitted to identify policy strategies. A Weaknesses – Opportunities, conservative or mini-maxi strategy was selected, owing to the relevance of system weaknesses (such as low investments, poor return of R&I to society or low R&I for AWM adaptation) and opportunities (such as the Green Agenda for the Western Balkans, Smart Specialization or regional partnerships). The policy roadmap was structured along three policy goals: strengthen R&I, strengthen AWM and identify / fund local R&I priorities for AWM. Policy goals included policy instruments promoting eco-efficient use of resources and sustainable development of rural areas.

Nisada Đuzelić, Nina Čamdžić, Dževad Durmišević, Amir Rekić, S. Hodžić, A. Prohic

Abstract Introduction: Melkersson Rosenthal syndrome (MRS) is a disease of multifactorial origin typically presented with a triad of symptoms including peripheral facial nerve paralysis, plicated tongue and orofacial edema. Diagnosing MRS requires the exclusion of other granulomatous diseases and the correlation of clinical with histopathological finding. Case presentation: We present the case of a 56-year-old female with a four-month history of lower lip and right mandible angle swelling together with a plicated tongue that appeared during COVID-19 infection. The patient was successfully treated with intralesional Triamcinolone Acetonide at a dose of 40 mg. Conclusion: The presented case is specific by its late onset since the patient experienced their first symptoms in fifties, which differs from the majority of cases where the diagnosis is usually established in young adults. Infectious factors are established as possible etiologic factors of MRS, but few cases are described to be triggered or worsened by COVID-19 infection.

M. Hodžić, N. Prljaca

: Variants of proportional navigation (PN) are perhaps mostly used guidance laws for tactical homing missiles. PN aims to generate commanding missile lateral acceleration proportional to line of sight (LOS) angular rate, so that missile velocity vector rotates in such a way to assure interception of a target. In order to generate commanding lateral accelerations, the guidance system needs measurements of LOS angular rate and the closing velocity between the missile and the target, or the missile velocity. A device which provides guidance information is referred to as the missile seeker. In the case of imaging based seekers (visible light (EO), infrared light (IIR)), LOS rate is estimated using imaging sensor, while closing or missile velocity is measured using appropriate sensors or guess estimated. In this paper, we present the design and simulation of a missile homing system which includes: true PN guidance law, linear multiloop acceleration autopilot, and gimbaled imaging based missile seeker. Target seeker uses advanced deep machine learning object detection YOLO (You only look once) model, for target detection and tracking as well as LOS rate estimation. Comprehensive simulation model, consisting of full 6DOF missile and controls dynamics, 3D world and camera model, is developed. Intensive simulation results show performances of the proposed missile homing system.

Simon McCluney, Danielle Park, D. Miller, Robert D Bloxham, Merima Mehić, Emma de Vries, Xuelu Wang, Robert W Wilkinson et al.

SMAD4 is a tumour suppressor gene that is mutated in up to 60% of pancreatic ductal adenocarcinoma (PDAC) tumours. Activins are members of the TGF-b signalling superfamily which signal through SMAD4 and are generally associated with an oncogenic process, with differing effects on tumour and stromal cells, such as cancer associated fibroblasts (CAFs). We sought to further elucidate the role of activin within PDAC and perturb activin signalling in vitro and in vivo. Analysis was performed of publicly available human datasets alongside human and murine single-cell RNA-sequencing datasets to study the effect of activin expression on survival and tumourigenesis. We developed anti-activin monoclonal antibodies to perturb activin signalling in PDAC mice, with deep analysis of tumour composition including immune cells and CAFs via a multitude of basic science techniques. We demonstrated that circulating activin levels are higher in PDAC patients than in healthy volunteers, whilst activin overexpression is associated with reduced overall survival in PDAC patients. Activin was shown to be predominantly expressed by contractile (collagen-depositing) CAFs, as opposed to inflammatory CAFs. Activin expression co-localises with fibroblasts, and anti-activin antibodies can reduce the collagen content of dense PDAC tumours. Additionally, anti-activin antibodies led to a statistically significant increase in CD4 and CD8 T-cell infiltration into murine PDAC tumours. We have shown that activin is overexpressed in PDAC, and high expression is associated with a more aggressive disease process. Anti-activin antibodies can alter the composition of desmoplastic PDAC tumours and increase the immune infiltrate of these typically “immune cold” tumours.

The sharpnose sevengill shark (Heptranchias perlo) is a rare and poorly understood deep‐sea species, with only a few records in the Adriatic Sea over the last two centuries and a significant gap in sightings. Throughout 2023, three new records are documented in the southernmost Adriatic Sea, found at depths ranging from 391 to 452 m off Vlorë. This study marks the first comprehensive health examination of a deep‐sea shark, investigating potential trauma and injuries resulting from trawling. It encompasses pathological and histopathological examinations, supplemented by magnetic resonance imaging (MRI). The research highlights alarming post‐capture mortality rates in this data deficient species, discusses further conservation implications, and proposes protective measures for the species. Beyond addressing critical knowledge gaps, this study advocates for collaborative efforts with local fishermen to establish long‐term monitoring and obtain data on the frequency and abundance of elusive species.

Osman Sinanović, Muhamed Lepuzanovic, Edin Bašagić

Motor neuron diseases (MNDs) are a group of relatively rare, progressive neurodegenerative conditions (with amyotrophic lateral sclerosis/ALS being the most common) characterized by degeneration of upper and lower motor neurons leading to motor and extra motor symptoms. The etiology of MND is believed to involve complex interactions of environmental, lifestyle, and genetic factors, but so far only a few convincing risk factors have been established. Several putative risk factors associated with sporadic cases have been suggested, including repetitive blows to the head and traumatic brain injury. ALS is considered a sporadic disorder in 90% of cases. The incidence of ALS in the United States is 1.5 to 2.2 per 100.000, but varies significantly by age, sex, and race. The incidence of ALS generally increases with age and peaks during the seventh decade of life. There is not a large number of relevant studies for reliable conclusions about the connection between sports and BMN. However, there is increasing interest in the role of contact sports (eg, American football and rugby) following the diagnosis of BMN in several high-profile professional athletes. Several case-control studies have found an increased risk of MND among people who engage in strenuous physical activity, but other studies of this type did not find this risk (association) or the association was negative. Several other studies have shown an increased risk of BMN with traumatic brain injury, while others have found no association. The risk of MND varies depending on the type of sport played. For many individual sports, no increased risk of BMN was observed, including cricket, basketball, tennis, swimming, hockey, volleyball, badminton, field hockey, sailing, rowing, diving and skiing. However, several meta-analyses have shown a 1.3 to 1.7 times higher risk of MND in athletes who suffer a head injury, compared to the general population. Experience shows that exercise can be physically and psychologically important for people with ALS. Although the results so far do not provide clear conclusions regarding physical therapy or/and exrecise regimens to maintain function and quality of life in people with ALS, we can say, for sure, that moderate exercise is not harmful. Regarding the type of exercise, moderate intensity and not very high frequency (two sessions per week), combining strength and aerobic resistance, may be the best option to see improvements in ALS patients and prevent fatigue that further impairs their quality of life.Key words: amyotrophic lateral sclerosis – sports – physical therapy

Faruk Husremović, Orhan Muharemović, Edis Đedović, A. Efendic, Jasmin Mušanović, R. Omerović, Hedim Osmanović, M. Busuladžić

A Computed Tomography Urography (CTU) scan is a medical imaging test that examines the urinary tract, including the bladder, kidneys, and ureters. It helps diagnose various urinary tract diseases with precision. However, patients undergoing CTU imaging receive a relatively high dose of radiation, which can be a concern. In our research paper, we analyzed the Computed Tomography Dose Index (CTDIvol) and Dose-Length Product (DLP) for 203 adult patients who underwent CTU at one of the most important regional centers in Bosnia and Herzegovina that sees a large number of patients. Our study included the distribution of age and sex, the number of phases within one examination, and different clinical indications. We compared our findings with the results available in the scientific literature, particularly the recently published results from 20 European countries. Furthermore, we established the local diagnostic reference levels (LDRLs) that can help set the national diagnostic reference levels (NDRLs). We believe our research is a significant step towards optimizing the protocols used in different hospitals in our country.

Casey Zhang, Yadira Villalvazo, Nerone O. Douglas, Dzana Katana, Anne E. Glenney, Pooja Humar, Baris Bengur, Alexandra M. Vagonis et al.

Aleksandra Dimitrijević, Slađana Marić, Ana Jocić, Danijela Tekić, Jasmina Mušović, Joana S. Amaral

Polyphenols are natural compounds with enhanced antioxidant properties. They are present in relatively high concentrations in fruit/vegetable by-products. Therefore, there is a need for the development of efficient and cost-effective methods for the separation and purification of these valuable compounds. Traditional extraction with organic solvents needs to be switched to novel methods that are more efficient, with reduced extraction times and low consumption of organic solvents. Aiming at developing sustainable processes for the separation and purification of phenolic compounds, we used three model compounds, namely resveratrol, quercetin, and gallic acid, to investigate ionic liquid-based aqueous biphasic systems (IL-ABSs) formed by cholinium-based IL in combination with polypropylene glycol with a molecular mass of 400 g/mol (PPG400). The ABS composition in the two-phase region was selected according to a previously determined phase diagram. Extraction studies indicated the preferential partition of resveratrol and quercetin toward the hydrophobic PPG-rich phase that is mainly dominated by its hydrophobic nature and the strong salting-out effect of ILs. On the other hand, due to its considerably hydrophilic nature, gallic acid preferentially migrates toward the IL phase. The achieved results from grape stem extract demonstrated high extraction efficiencies of cholinium dihydrogen phosphate (~99% for resveratrol for the PPG phase and 78% for gallic acid for the IL phase), with considerable selectivity, demonstrating promising outcomes for potential applications.

P. Kovačević, Jovana Malić, T. Kovačević, S. Dragić, Biljana Zlojutro, Milka Jandrić, Danica Momčičević, Branka Cancarevic-Djajic et al.

Objective: This retrospective (matched paired) clinical trial aimed to compare the efficacy of dexamethasone vs. methylprednisolone at equipotent (high) doses in patients with coronavirus disease 2019 (COVID-19)-associated acute respiratory distress syndrome (ARDS). Methods: A total of 347 patients with moderate and severe COVID-19-associated ARDS were administered either a high (equipotent) dose of dexamethasone (32 mg) or methylprednisolone (180 mg) for a duration of up to 10 days. All participants received the standard of care for critically ill COVID-19 patients. Results: The primary outcomes included length of stay in the ICU, ICU mortality, and discharge from the hospital. Based on the obtained results, a tendency towards more favorable clinical outcomes concerning the length of stay in the ICU (in the group of patients treated with non-invasive mechanical ventilation (NIV), p<0.05), ICU mortality, and discharge from the hospital (in the group of patients who were intubated, p<0.05) in patients receiving the high dose of dexamethasone compared to those receiving methylprednisolone was observed. Conclusion: It appears that severe cases of COVID-19, especially intubated ones, treated with high doses of dexamethasone have a more favorable clinical outcome than the use of equipotent doses of methylprednisolone. However, larger multicenter studies are needed to validate our observations.

Abstract Parasitic diseases of wild animals represent an important area of research. In addition to the significant impact on wildlife health and fitness, many parasitic diseases have zoonotic implications. Due to limited scientific information, this research aimed to investigate parasitic diseases in wildlife in Bosnia and Herzegovina (B&H), focusing on the Federation of Bosnia and Herzegovina (FB&H), emphasizing zoonotic species. In the period from April 2020 to November 2022, we conducted research on 9 wildlife species. We analyzed fecal samples to detect and identify diagnostic stages (eggs, larvae, cysts, and oocysts) of various animal endoparasites using coprological methods, such as sedimentation, flotation, and the Baermann technique. The MERIFLUOR® Cryptosporidium/Giardia test was also used for the detection of Cryptosporidium oocysts and Giardia cysts. In the case of red foxes, intestinal samples were examined using the intestinal scraping technique to detect adult helminths. All collected muscle samples were subjected to the artificial digestion method for Trichinella detection. From 1,278 samples, 70.9% were positive. Parasitic infections were confirmed in 15.9% (11/69) of bears; 83.7% (262/313) of red foxes; 67.6% (44/65) of wolves; 25% (1/4) of wildcats; 20% (1/5) of badger; 43.7% (7/16) of martens; 39.7% (76/191) of wild boars; 84.5% (350/414) of deer, and 77.1% (155/201) of hares. The finding of zoonotic parasites (Toxocara canis, Uncinaria spp., Trichinella spp., Echinococcus spp. etc.) is particularly important due to their potential detrimental effects on human health, which highlights the need for further investigations.

Sanel Teljigovic, Tina Dalager, Nina Odgaard Nielsen, Lars Holm, Mette Bahn Ejvang, G. Sjøgaard, K. Søgaard, L. F. Sandal

Objective Older adults constitute a heterogeneous group, and the focus of the individual physical exercise is often subject to the reasoning and experience of health professionals or exercise physiologists who prescribe them. Thus, this is the first effort to explicitly conceptualise the planning of individualised physical exercise training (IPET) for older adults in an outpatient setting and investigate individual exercise preferences. Design The concept of IPET was developed by researchers, exercise physiologists and health professionals from a real-life outpatient setting using an iterative approach. Health indicators assessing aerobic capacity, strength, balance and musculoskeletal pain/discomfort sites form the basis of physical exercise recommendations. A cross-sectional study was conducted to assess the basis of implementing IPET. Setting Outpatient setting. Participants We included 115 older adults (70 females) from an outpatient setting with a median age of 74 years. Outcome measures Health indicators assessing aerobic capacity, strength, balance and musculoskeletal pain/discomfort sites were collected and informed the concept of IPET that structures exercise programmes based on the individual citizen’s needs and physical exercise preferences. Exceeding a health indicator cut-point results in exercise content mitigating the risk associated with the health indicator. Results We included 115 older adults (70 females) from an outpatient setting median age of 74 years. Approximately two-thirds of participants exceeded at least one health indicator cut-point for aerobic training. One-third of the participants exceeded the cut-point for upper extremity strength, and almost all participants >99% exceeded the cut-point for lower extremity strength. Approximately two-thirds of the participants exceeded the cut-point for functional/balance training. The most prevalent site of musculoskeletal pain was the lower extremities. Eight of 20 training combinations were used, clustering the 115 participants primarily in three main training combinations. Discussion This study shows that older adults vary in physical functioning, indicating that exercise preferences and rehabilitation needs are individual. Trial registration number NCT04862481.

Dragan Babić, Mario Babić, Marina Ćurlin, Darjan Franjić

In recent decades, conventional medicine has begun to include natural remedies and spiritual therapy in the treatment of people with mental disorders, and in recent years, physicians and healthcare professionals more often refer to alternative and complementary methods in the treatment of mental disorders. Alternative medicine includes “other treatments” and a more suitable term would be complementary medicine which supplements the definition of conventional medicine accepted by the World Health Organization. After the rise of pharmaceutical industry in the second half of the 20th century and significant advancement in the treatment of mental disorders, comes a period of disappointment and acceptance of the fact that synthetic drugs are not omnipotent and may have serious and unpleasant side-effects. Due to this fact, there is a growing interest in the treatment of mental disorders with the use of complementary methods. It is important to note that these methods are not a substitute for standard treatment procedures and their appropriate application does not diminish the importance of classical treatment of psychiatric disorders. Numerous patients refuse classical therapy and seek the help of complementary medicine methods. It is therefore important for physicians and healthcare professionals to have knowledge of complementary medicine which is science based and advises on treatment methods provided they are scientifically justified. Key words: complementary medicine, psychiatry

1. 3. 2024.
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Metin Özdemir, T. Özdemir, Nazlı Helvacı, A. Kural, S. Kuraş, Ö. Can, Fatih Hacımustafaoğlu, Berina Hasanefendić et al.

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